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Trouble sleeping

Many people have difficulties sleeping during and after breast cancer. Read about why this is, what you can do to improve your sleep, and available treatments.

1. What causes sleep problems?

Difficulty sleeping (insomnia) can be caused by:

  1. Stress and anxiety
  2. Changes to your sleep pattern
  3. Changes to your daily routine
  4. Side effects of treatment

Some treatments have side effects that can affect your sleep. For example, hormone (endocrine) therapy can cause menopausal symptoms, which can mean sleep is disrupted by night sweats or hot flushes.

Chemotherapy can also affect your sleep at night because it can make you feel tired and take naps during the day. If you’re taking steroids alongside your chemotherapy, these can also make it harder for you to fall asleep at night.  

It may take some time for your sleep pattern to return to normal once your treatment has finished. If you’re worried about fatigue, speak to your treatment team.

2. What can I do to improve my sleep patterns?

Speak to your treatment team after surgery

If you’re having trouble sleeping because of pain or discomfort after surgery, your treatment team may be able to give you guidance on the best sleep positions.

Try to be active

Try to get some regular moderate exercise (such as walking, cycling or swimming) during the day. Avoid exercising late in the evening as this can disrupt your sleep.

Eat well and stay hydrated

Try not to have drinks containing caffeine after mid-afternoon. These include tea, coffee and many fizzy drinks.

Limit the amount of alcohol you drink. Alcohol may help you get to sleep but it can also cause disrupted sleep.

Take your medication as directed

Make sure you take your medication, such as steroids, as directed by your treatment team as the timing may affect your sleep.

Limit daytime naps

Limit the number of daytime naps you have and keep them to less than half an hour at a time. Avoid late afternoon naps.

Stick to a sleep routine

Try to go to bed and get up at the same time each day. Some people think if they have a bad night’s sleep they should go to bed early the next night, but this can make the problem worse. Most people require 6 to 8 hours of sleep.

Think about how much sleep you get on average each night and go to bed at a time that allows you to get the sleep you need. For example, if you sleep for 6 hours a night and get up at 6am, you should try to go to bed before midnight.

Relax before bed

Do something relaxing before bedtime – you could listen to some quiet music or an audiobook, have a warm bath or practise a relaxation technique such as mindfulness.

Avoid using screens (such as watching TV or using your tablet or mobile devices) before bed.

Make sure your bedroom is quiet, dark and a comfortable temperature.

Try not to use your bedroom for activities like working, using your computer or watching TV.

Get up if you’re struggling to sleep

If you can’t get to sleep or you wake up in the night and can’t get back to sleep, get up for a bit rather than lying in bed. Read or listen to the radio until you start to feel tired, then go back to bed.

3. What treatments are available?

Talking therapies

Talking therapies such as counselling or cognitive behavioural therapy (CBT) can be useful and might help you change your patterns of thinking and behaviour. If you think counselling or CBT could help, talk to your GP or treatment team. Some counsellors will also be able to give you a guided relaxation CD to use at home.

Complementary therapies

You may find complementary therapies such as yoga, meditation and relaxation techniques help you relax and sleep better.


You may be recommended a short course of sleeping tablets to help you sleep. You can talk to your GP or treatment team about this.

Helpful resources

You may find it helpful to listen to this short audio guide on sleep problems from the NHS website. The NHS also has a range of information and resources to help you sleep better.

Some people find the Calm and Sleepio apps helpful. Sleepio is only available on the NHS in certain areas, or you can access it with a referral from Macmillan.

You can find helpful tips on how to sleep better in the How to Sleep guide

4. Further support

If you’re having difficulties sleeping, speak to your treatment team or GP who should be able to offer advice and support.

You can also call our free helpline (see below) to talk through your concerns and ask any questions you might have.

You can also join our online forum and talk to people who have also had trouble sleeping – they may be able to offer tips for sleeping better and support.

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Quality assurance

Last reviewed in March 2024. The next planned review begins in March 2027.

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